7Department of Social and Behavioral Sciences, Harvard T H Chan School of Public Health, Harvard, USA

8Department of African and African American Studies and of Sociology, Harvard University, USA

9Department of Psychiatry and Mental Health, University of Cape Town, South Africa

Correspondence to: D R Williams dwilliam{at}hsph.harvard.edu

Accepted 12 May 2015

NHS organisations are now being judged on indicators of ethnic diversity. Naomi Priest and colleagues look at the international evidence on how they should tackle discrimination

For decades research has shown that discrimination, harassment, and exclusion are pervasive experiences for staff from black and minority ethnic (BME) backgrounds in the National Health Service.123456 In recognition of limited progress in achieving the goals of the now decade old NHS Race Equality Action Plan,7 the NHS has agreed a mandatory workforce race equality standard. The standard requires NHS organisations to collect baseline information from April 2015 on nine indicators of workforce equality for ethnic minority staff, including representation on boards, and to publish annual updates on these metrics (box). Organisations that fail to make progress on these metrics will be in breach of the NHS standard contract, and this will affect whether regulators judge them to be “well led.”89 We review the international evidence on the effectiveness of diversity initiatives to assess how best to achieve the standard’s intended outcomes.

Indicators for the workforce race equality standard

Workforce metrics

For each of these four workforce indicators, the standard compares the metrics for white and BME staff

Percentage of BME staff in bands 8-9 (very senior managers, including executive board members and senior medical staff) compared with the percentage of BME staff in the overall workforce

Relative likelihood of BME staff being appointed from shortlisting compared with that of white staff being appointed from shortlisting across all posts

Relative likelihood of BME staff entering the formal disciplinary process, compared with that of white staff entering the formal disciplinary process, as measured by entry into a formal disciplinary investigation. (Based on data from a two year rolling average of the current year and the previous year)